A&T Ethiopia Maternal Nutrition Endline Survey 2021: Recently Delivered Women

Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding, and complementary feeding practices. In Ethiopia, A&T integrated a package of maternal nutrition interventions into existing ANC services delivered through government health facilities (interpersonal counseling on diet quality during pregnancy, counseling on iron-folic acid (IFA) supplementation, adequate weight-gain monitoring, counseling on early breastfeeding practices, and systems strengthening through training and supportive supervision) and community platforms (home visits, Pregnant Women Conferences/Mother Support groups, and community gatherings) that align with the latest global evidence. This dataset is part of a survey that was conducted to gather endline data for the impact evaluation of the interventions. The overall study objective was to determine the feasibility of integrating locally relevant maternal nutrition interventions into existing ANC services and determine the impact on diet quality and utilization of nutrition interventions during pregnancy. Research questions include: 1) What is the program impact on maternal practices: (1) consumption of diversified foods during pregnancy; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key maternal nutrition interventions during ANC be improved through system strengthening approaches? 3) What factors influenced the integration and strengthening of maternal nutrition interventions into the government ANC service delivery platform? The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys at baseline and endline. The unit of randomization is the health center and associated health posts in the catchment area. The endline survey was conducted in August-September 2021 by Addis Continental Institute of Public Health (ACIPH), the in-country research collaborator for the survey. The endline survey included the following: 1) Pregnant women questionnaire, 2) Recently delivered women questionnaire, 3) Health Extension Worker (HEW) questionnaire, 4), Nurse-midwife questionnaire, 5) Health facility observation checklist, and 6) ANC observation checklist and exit interview. The recently delivered women interviews were conducted using pretested, structured questionnaires. Information was collected on household composition, household socioeconomic status, obstetric history, use of ANC, exposure to ANC, maternal nutrition and breastfeeding knowledge and practices, pregnancy and postnatal care, household food security, social desirability, decision-making power, mental health, anthropometry, husband’s health and nutrition knowledge, and husband’s perceptions of maternal nutrition and roles of husbands and other family members during pregnancy.

Alive & Thrive（A&T）是一项旨在支持扩大营养干预措施的倡议，通过改善孕产妇营养、母乳喂养及辅食喂养实践，以挽救生命、预防疾病并促进健康成长与发展。在埃塞俄比亚，A&T将一套孕产妇营养干预措施整合至政府卫生机构提供的现有产前护理（ANC）服务中（包括孕期饮食质量的人际咨询、铁叶酸补充剂（IFA）咨询、适当体重增长监测、早期母乳喂养实践咨询，以及通过培训与支持性监督强化系统），同时整合至符合最新全球证据的社区平台（如家访、孕妇会议/母亲支持小组及社区集会）。该数据集是为评估干预措施影响而开展的终线调查数据收集工作的一部分。研究总体目标为确定将本地适配的孕产妇营养干预措施整合至现有ANC服务的可行性，并评估其对孕期饮食质量及营养干预措施利用率的影响。研究问题包括：1）项目对孕产妇实践的影响：（1）孕期多样化食物摄入情况；（2）孕期IFA补充剂使用情况；（3）早期母乳喂养实践情况？2）通过系统强化方法能否提升ANC期间关键孕产妇营养干预措施的覆盖率与利用率？3）哪些因素影响了孕产妇营养干预措施与政府ANC服务提供平台的整合及强化？本评估采用双臂整群随机非盲试验设计，包含基线与终线两次横断面调查，随机化单位为卫生中心及其服务辖区内的相关卫生站。终线调查于2021年8月至9月由该国研究合作方亚的斯亚贝巴大陆公共卫生研究所（ACIPH）开展，涵盖以下内容：1）孕妇问卷；2）近期分娩妇女问卷；3）卫生推广工作者（HEW）问卷；4）护士-助产士问卷；5）卫生机构观察清单；6）ANC观察清单及出口访谈。对近期分娩妇女的访谈采用经预测试的结构化问卷进行，收集的信息包括家庭构成、家庭社会经济状况、产科史、ANC服务利用情况、ANC服务接触情况、孕产妇营养与母乳喂养知识及实践、孕期与产后护理、家庭粮食安全、社会期望、决策权、心理健康、人体测量学数据、丈夫的健康与营养知识，以及丈夫对孕产妇营养的认知及丈夫与其他家庭成员在孕期的角色。